Project Summary NYU School of Medicine, the Mailman School of Public Health, the Wadsworth Laboratories of the NYS Department of Health, and Cincinnati Children's Hospital Medical Center respond to PAR-16-098, proposing to leverage two unique and contemporaneous cohorts to examine chemical and psychosocial stressors in relationship to proximity to the WTC site and self-reported exposures, and evaluate birth, neurodevelopment and cardiometabolic outcomes. The first is comprised of mothers who delivered in one of three lower Manhattan hospitals in the months after the disaster, and the other is the northern Manhattan-based Columbia Children's Environmental Health Center (NM) cohort. The NM cohort includes children born just before and after September 11, 2001 permitting nested evaluations of stress-related exposures. Except for cardiometabolic outcomes, the data are already available including freshly obtained measurements of POPs, which we will extend to include PFCs with NIOSH support. In both populations, neurodevelopmental outcomes have been assessed through 6-7 years of age. Taking advantage of temporal and geographic differences in these cohorts, we will compare both psychosocial and chemical exposures and their association with outcomes among children who were and were not prenatally exposed to the WTC disaster. This study leverages previously measured biomarkers and prospectively collected data on psychosocial stress. In addition, we will be the first to examine physical health of adolescents exposed in utero to the WTC disaster. While other studies have examined non-invasive measurements of central and peripheral arterial stiffness, ours is one of the first to examine chemical exposures in relation to these endpoints in adolescence. Preclinical measures included in the proposed project may be more sensitive cardiovascular endpoints reflecting environmental influences in homogeneous populations such as young children and adolescents. The study is led by an international leader in children's environmental health who has conducted the only in-depth physical health studies of children exposed to the disaster (Trasande) with leaders of two large birth cohorts, one including children born in three lower Manhattan hospitals; and another of upper Manhattan children that will serve as a comparison (Herbstman, Perera, and Rauh). If WTC chemical exposures are associated with these outcomes, the study findings could facilitate proactive interventions such as treatment with antihypertensive medications which have been documented to prolong survival among adults with suboptimal cardiovascular profile.